Aspirin administered to women at 100 mg every other day produces less platelet inhibition than aspirin administered at 81 mg per day: implications for interpreting the women’s health study

Swaim, Lisa; Hillman, Robert W.

doi:10.1007/s11239-008-0262-6

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…However, for efficacy, the dose interval is also a variable. A recent comparison of 81 mg/day aspirin vs. 100 mg every other day to healthy women -mimicking the protocol of the Womens´ Health study, showed that the once daily administration produced stronger and less variable inhibition of platelet function than the 100 mg every second day (65). This suggests that the platelet turnover rate is a variable of aspirin's antiplatelet effect even in healthy volunteers, in particular at (very) low doses An enhanced platelet turnover rate in certain diseases, therefore, might shorten the time of sufficient blockade of platelet COX-1 after aspirin administration and, thereby, reduce its antiplatelet effect and clinical efficacy.…”

Section: Unsolved Issues With Aspirin and Future Aspects Aspirin Vs mentioning

confidence: 99%

Why we should not skip aspirin in cardiovascular prevention

Schrör¹

2016

Hamostaseologie

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Section: Unsolved Issues With Aspirin and Future Aspects Aspirin Vs mentioning

confidence: 99%

Why we should not skip aspirin in cardiovascular prevention

Schrör¹

2016

Hamostaseologie

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“…In a direct comparison of aspirin 81 mg daily versus 100 mg every other day in women who otherwise would have met inclusion criteria for The Women's Health Study, daily aspirin was associated with less aspirin resistance than every other day aspirin, suggesting that the results of the Women's Health Study may have underestimated the cardioprotective effects of aspirin. 52 In addition, the Antithrombotic Trialists' Collaboration found in both men and women that doses of aspirin less than 75 mg per day had a nonsignificant decrease in vascular events. 2 Thus, in the Women's Health Study, the total dose of aspirin may simply have been too low, possibly accounting for the observed ineffectiveness in women.…”

Section: Womenmentioning

confidence: 99%

Aspirin Resistance: Current Status and Role of Tailored Therapy

Grinstein

Cannon

2012

Clinical Cardiology

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Aspirin is integral in the primary and secondary prevention of coronary artery disease and acute coronary syndrome. Given the high clinical importance of aspirin in the management of coronary artery disease, much attention has been directed towards the concept of “aspirin resistance.” Unfortunately, the term aspirin resistance is ill‐defined in the literature, leading to a large variance in the reported prevalence of this phenomenon. In this review, the current understanding of aspirin resistance is discussed. Commonly used functional and diagnostic tests of platelet function, including their strengths and weakness, are reviewed. We next discuss several proposed mechanisms of aspirin resistance and special high‐risk groups at risk for aspirin treatment failure. We then discuss optimal dosing and diagnostic strategies for those populations at risk for aspirin resistance with a focus on tailored aspirin therapy for high‐risk groups. Finally, future topics of interest in the field of aspirin resistance are considered. Clin. Cardiol. 2012 doi: 10.1002/clc.22031Jonathan Grinstein has no funding, financial relationships, or conflicts of interest to disclose. Christopher P. Cannon receives research grants/support from the following companies: Accumetrics, AstraZeneca, Essentialis, GlaxoSmithKline, Merck, Regeneron, Sanofi, and Takeda. He is also on the advisory board (but funds donated to charity) for Alnylam, Bristol‐Myers Squibb, and Pfizer. He is a Clinical Advisor, equity in Automedics Medical Systems.

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“…However, the variation in doses in the trials was small and is unlikely to be clinically significant. Nevertheless, in healthy women, aspirin 100 mg every other day, the dose used in the WHS, produced less platelet inhibition than 81 mg daily [27], although it is unclear if differences in a platelet function assay are clinically meaningful. It is also noteworthy that a single trial, the WHS, which enrolled exclusively women, contributed approximately 40% of the total subjects, and approximately 78% of the female subjects to the meta-analyses.…”

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confidence: 99%

Gender Differences in the Primary Prevention of Stroke with Aspirin

Adelman

Lisabeth

Brown

2011

Womens Health (Lond Engl)

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Aspirin is used to prevent ischemic stroke and other types of cardiovascular disease. Seven trials of aspirin focusing on the effectiveness of primary prevention of stroke and other cardiovascular events have been performed, but three of these did not include women. Data from these trials, and one meta-ana lysis, suggest that aspirin prevents myocardial infarction in men and stroke in women, although the findings in women were driven by the results of a single large study, and a subsequent meta-ana lysis did not find a gender difference. The reasons for the possible gender differences in aspirin's effectiveness are not entirely clear. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Future Medicine Ltd. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at www.medscape.org/journal/wh; (4) view/print certificate. Release date: 25 May 2011; Expiration date: 25 May 2012 Learning objectivesUpon completion of this activity, participants should be able to:• Describe gender-specific findings from trials of aspirin focusing on the effectiveness of primary prevention of stroke and other cardiovascular events• Describe professional society guidelines regarding use of aspirin for primary prevention of stroke and other cardiovascular events in women• Describe risks of aspirin used for primary prevention of stroke and other cardiovascular events in women REviEw -Adelman, Lisabeth & Brown CMEIn the USA, stroke is the third leading cause of death and the leading cause of disability [1]. While treatments for acute stroke and options for secondary stroke prevention have proliferated in recent years, the greatest potential to reduce the impact of stroke lies in primary prevention. Every year in the USA there are close to 800,000 strokes [1]. While approximately 185,000 are recurrent strokes, approximately three-quarters are new events and greater than half occur in women [1]. Risk factors for stroke such as hypertension, smoking, diabetes, physical inactivity and obesity are becoming more prevalent in an aging US population. Lost earnings and caregiving costs due to stroke put a tremendous burden on society and underscore the need for effective preventive strategies [2]. Given disparities in stroke burden by gender, these s trategies should be assessed in both men and women.The ancient Greeks knew that willow bark had analgesic properti...

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Aspirin administered to women at 100 mg every other day produces less platelet inhibition than aspirin administered at 81 mg per day: implications for interpreting the women’s health study

Cited by 10 publications

References 23 publications

Why we should not skip aspirin in cardiovascular prevention

Why we should not skip aspirin in cardiovascular prevention

Aspirin Resistance: Current Status and Role of Tailored Therapy

Gender Differences in the Primary Prevention of Stroke with Aspirin

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